腕骨运动学的研究现状

The current research of normal carpal kinematics

腕骨运动学的研究仅有100多年的历史,由最初在尸体上的研究过渡到最近几年才发展起来的活体研究。基于尸体上的研究植入不透X线的标记物或者经皮针状物,应用双平面的放射照相术,低频率磁场技术以及从CT图像进行骨的三维重建来跟踪每块腕骨的运动轨迹得到腕骨三维运动信息。基于活体上的研究主要应用CT扫描图像进行骨的三维重建及先进的配准技术来分析腕骨运动学。两种研究方法的结果大部分是一致的,即远排列腕骨为一功能整体,近排列腕骨各骨之间的活动度较大。在尸体上的研究创立了腕骨运动学的基础。活体上的研究与尸体上的研究相比,仅发现了近排腕骨间的较大非平面运动,而且有比较大的个体之间差异。由于这两种方法各存在其局限性,至今仍没有确立腕骨运动学的一个单一模型。本文综述了有关正常腕骨运动学的研究进展。

The study of normal carpal kinematics has a history of only about 100 years. The initial in vitro research has shifted to the recent in vitro research. Information about the 3 dimensional movements of the carpal bones in vitro was obtained in studies using implanted radiopaque markers or transcutaneous pins with biplanar radiography, low frequency magnetic field technology and reconstructing the geometry of the bones from computed tomography (CT). On the other hand, information about the 3 dimensional movements of the carpal bones in vitro was obtained in studies reconstructing the geometry of the bones from computed tomography (CT) and using the advanced matching techniques. Most of the results obtained through the two methods are in concordance. The distal row of bones is relatively tightly bound to one another and the proximal row of bones is less so but still moving together. The foundation of the carpal kinematics was laid by in vitro studies. In vitro data largely concur with in vitro data, and only larger out of plane motions within the proximal carpal row are described in most in vitro studies. In vitro studies have also showed larger interindividual variations. Due to the limitations of both in vitro and in vitro studies, so far there has been no unanimity about the interpretation of carpal functional anatomy. In this paper, the authors summarize the research advances in normal carpal kinematics.